Medication Administration / Parenteral

Question 1

IM: Deltoid

Answer 1

1. 2-3 finger widths below acromion process
2. 1-1.5” needle length
3. 22-25 gauge (adult)
4. maximum of 1mL
5. angle of 90°

Question 2

IM: Ventrogluteal

Answer 2

1. Make a “V” above greater trochanter and off of the ASIS
2. 1.5” needle length
3. 22-25 gauge (adult)
4. maximum of 3mL (only 2mL if adult is small, if a child)
5. angle of 90°

Question 3

IM: Vastus Lateralis

Answer 3

1. 1 hand width below greater trochanter and 1 hand width above knee
2. 5/8-1” needle length
3. 22-25 gauge (adult)
4. maximum of 3mL (only 2mL if adult is small, if a child)
5. angle of 90°

Question 4

Z-Track

Answer 4

1. Used for IM injections into large, deep muscle
2. 5/8-1.5” needle length
3. 22-25 gauge (adult)
4. maximum of 3mL (only 2mL if adult is small, if a child)
5. angle of 90°

Question 5

SubQ: Abdomen

Answer 5

1. 1” below the umbilicus and btwn the ASIS
2. 3/8-1” needle length&raquo_space; 5/8” is most common
3. 25-27 gauge
4. maximum of 1mL
5. angle of 45-90°

Question 6

SubQ: Upper Arm

Answer 6

1. Fatty area at back of upper arm
2. 3/8-1” needle length&raquo_space; 5/8” is most common
3. 25-27 gauge
4. maximum of 1mL
5. angle of 45-90°

Question 7

SubQ: Thigh

Answer 7

1. 1 hand width below greater trochanter and 1 hand width above knee
2. 3/8-1” needle length&raquo_space; 5/8” is most common
3. 25-27 gauge
4. maximum of 1mL
5. angle of 45-90°

Question 8

ID: Inner Aspect of Forearm

Answer 8

2. 3/8-5/8” needle length
3. 25-27 gauge
4. 0.01-0.1mL
5. angle of 5-15°

Question 9

ID: Upper Chest

Answer 9

2. 3/8-5/8” needle length
3. 25-27 gauge
4. 0.01-0.1mL
5. angle of 5-15°

Question 10

ID: Upper Back

Answer 10

2. 3/8-5/8” needle length
3. 25-27 gauge
4. 0.01-0.1mL
5. angle of 5-15°

Question 11

Intramuscular Injections

Answer 11

a) best blood supply, so fastest absorption rate
b) do NOT aspirate immunizations
c) needle size varies according to patient size

Question 12

Subcutaneous Injections

Answer 12

a) fat tissue; little blood supply, so prolongs absorption
b) do NOT aspirate EVER!
c) needle size varies according to patient size
d) for the “no pinch” method, use a 90° angle and a 5mm needle length

Question 13

Intradermal Injections

Answer 13

a) into skin, no blood vessels
b) do NOT aspirate EVER! and NO MASSAGE!
c) makes a bleb when done correctly
d) use for allergy testing and PPD

Question 14

Name the four types of insulin and their routes of administration.

Answer 14

1. Rapid-Acting (SubQ)
2. Short-Acting/Regular (SubQ; is also approved for IV or IM use)
3. Intermediate-Acting/NPH (SubQ)
4. Long-Acting (SubQ; cannot be mixed with other insulin)

Question 15

Rapid-Acting

Answer 15

Onset&raquo_space; 10-30 min
Peak Effects&raquo_space; 0.5-3 hr
Duration of Action&raquo_space; 3-6.5 hr
Names&raquo_space; Insulin lispro, Insulin aspart, Insulin glulisine

Question 16

Short-Acting/Regular

Answer 16

Onset&raquo_space; 30-60 min
Peak Effects&raquo_space; 1-5 hr
Duration of Action&raquo_space; 6-10 hr
Names&raquo_space; Regular insulin (Brand name ending with a stand-alone “R”)

Question 17

Intermediate-Acting/NPH

Answer 17

Onset&raquo_space; 1-2 hr
Peak Effects&raquo_space; 6-14 hr
Duration of Action&raquo_space; 16-24 hr
Names&raquo_space; Isophane insulinsuspension

Question 18

Long-Acting

Answer 18

Onset&raquo_space; 0.8-2 hr
Peak Effects&raquo_space; Plateau or peakless
Duration of Action&raquo_space; up to 24 hr
Names&raquo_space; Insulin glargine (Lantus), Insulin detemir (Levemir)